122 MEDICAL JURISPRUDENCE 3. Changes in the skin. 4. Cooling of the body. 5. Cadaveric lividity, hypostasis, suggilation or post-mortem staining. 6. Cadaveric changes in the muscles. 7. Putrefaction or decomposition. 8. Adipocere. 9. Muminification. 1. ENTIRE AND CONTINUOUS CESSATION OF CIRCULATION AND RESPIRATION Ordinarily these signs are considered sufficient to determine that death has actually taken place, but these alone should not be relied on as absolute signs to avoid premature burial or cremation, inasmuch as persons like hiber- nating animals are known to have been resuscitated to life after having re- mained for some time in a condition in which the action of the heart and lungs was in abeyance and the muscles stiff and motionless. This state of suspended animation lasting from a few seconds to half an hourwor more may be found in cases of trance, yog, catalepsy, hysteria, as well as in cholera, sunstroke, concussion, drowning, hanging, tetanus, convulsions, chloroform poisoning and the so-called still-born infants. Major N. C. Kapur7 I.M.S., reports a case of resuscitation after cessation of the vital functions for over fifteen minutes. A Hindu male, 80 years old, was brought to the Medical College Hospital, Calcutta, at 10 p.m. on July 13, 1925, suffering from severe dyspnoea, the result of laryngeal obstruction due to a malignant growth of the larynx. As his case was urgent, he was taken straight to the operating theatre for the perform- ance of tracheotomy. When the patient was placed on the table, he suddenly stopped breathing. On examination, the heart sounds were found absent, the pupils were dilated and the eyes were fixed. Artificial respiration was immediately started and tracheotomy was performed when the patient was apparently dead. The patient's chest was conti- nuously flicked with a cold, wet towel. For fully fifteen minutes there was no response. There was complete cessation of breathing, heart sounds were absent, there was no pulse at the wrist, and the patient's face had the usual cadaveric characters. Just when all hopes seemed to have been lost, the patient's chest was flicked in a forcible manner, and to the surprise of everybody present the patient took a shallow breath. The flicking was continued and after a minute the patient took another breath. The pulse was now perceptible at the wrist and the heart sounds could just be heard. The respiration gradually established itself. A cases is also recorded where cardiac arrest of forty minutes' duration occurring during pneumonectomy on a 16-year-old boy was followed by permanent recovery. Cardiac massage and artificial respiration were tried, and a mixture of 80 mg. of procaine hydrochloride and 1 mg. of oxygen-epinephrine was injected directly into the left ventricular cavity. A case ° of Samadhi (Yog) occurred in Bombay. At 5 p.m. on Wednesday, the 15th February 1950, one Ramdasji Maharaj of Girnar went into Samadhi in an air-tight subterranean concrete cubicle on the Marine Lines ground. The walls of the cubicle, which measured 5J feet by 4f feet, were constructed of slabs of concrete, 7 inches thick, firmly cemented at the edges to make the cubicle air-tistht and water-tight; the total air capacity of the cubicle was about 216 cubic feet. The lid or roof of this cubicle which was cemented in place afterwards was another slab of concrete, 3 inches thick. All six walls of the concrete cubicle were lined or studded with thousands of old rusty nails, each being 3 inches long. Exactly 56 hours after the commencement of the Samadhi a narrow opening was bored into the lid of the cubicle, and with the aid of a fire hose about 1,400 gallons of water were pumped into the cubicle by the Bombay Fire Brigade. The narrow opening was subsequently sealed. After about 6£ hours on the morning of Sundav the 19th February the subterranean basin was broken open, and the Swami was lifted in an unconscious condition from inside by a few volunteers and carried to an adjoining specially raised dais. On examination he was found in a state of semi- consciousness or stupor with closed eyes and flaccid limbs. The pupillary reflexes were present but sluggish. The pulse was regular, 80 per minute and was of low volume. The 7. Ind. Med. Gaz., Dec. 1925, p. 582; vide also Shelley, Kenya Med. Jour., Nairobi, East Africa, Seu. 1926, p. 174; Younsr, Brit. Med. Jour., Aug. 3, 1935, p. 230. 8. Arthur S. W. Touroff and Milton H. Adelman, J. Amer. Mad. Assoc., March 26, 1949, Vol. 139, p. 844; see also T. L. Hyde and Leo V. Moore, J. Amer. Med. Assoc,, July 1, 1950, p. 805 ; Henri L. M. Roualle, Brit. Med. J., Sep. 23, 1950, p. 712. 9. Times of India, Feb. 20, 1950; see also R. J. Vakil, Lancet, Dec. 23, 1950, p. 712.